Dr. Goswami Parth Rajendragiri
Pathology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
Since last year, I am having a lot of health problems such as back pain, finger joint dull pain, chest inflammation, irritation at the penile area, inflammation inside the penile hole, body irritation, body weakness, and fever. I often do sense inside my head, i.e., pricking with pins and needles and flu-like symptoms all the time.
The reasons for the above-mentioned problems are due to unprotected sex with a creature (dog). Under the heavy influence of alcohol, such a blunder was committed. I have an apprehension of contracting rabies from that encounter. Can rabies be sexually transmitted? Please suggest to me what test should I need to do to rule out the above-mentioned symptoms. I have great hope in you as you are one of the most experienced and best pathologists. Please advise me the test so that I can perform the test and revert it to you for treatment.
Hello,
Welcome to icliniq.com.
Rabies can spread sexually but your symptoms do not classically point towards rabies infection. Neurological symptoms like confusion, nausea, excess salivation, etc., are missing. So the chance of rabies is less in my opinion. However, for rabies, testing multiple samples like saliva, spinal CSF fluid, etc., like an examination is needed.
You can rule out leptospirosis by serological ELISA testing as you have a history of sex with the dog. There are many zoonotic diseases which means those infections which spread from animal to human. HIV also can be ruled out by ELISA testing. So your detailed evaluation is needed to do further work up.
For primary work-up, you can investigate as follows. Blood pressure measurement, serum all vitamin B estimation, SGPT, SGOT, urea, creatinine estimation, ESR, full CBC, serum ionized calcium estimation, serum vitamin (OH) D estimation. You can revert back with reports. For your detailed physical examination, you need to consult a nearby internal medicine specialist.
Patient's Query
Thank you doctor,
It is a family dog but not vaccinated. As per my observation, it is a good dog. Since for the last one and a half years, there is no sign of disease in the dog. Can a good dog transmit rabies? The dog is still alive, or does every dog have rabies virus? Or is rabies present in unhealthy dogs? Or every unvaccinated dog do carry the rabies virus in them?
If found out the presence of rabies through a saliva test, then is there any step to prevent or cure the infection? I took two rabies vaccines after seven months from the day it happened. During bedtime, I often felt a tingling sensation in the penile area, insomnia, some sort of ringing sound in the ear, etc. As you have mentioned neurological symptoms like confusion, mean what? What types of confusion? If I gave my saliva for the test at the test center, is the test reliable? How many days does it require to get results? And what is the cost of the test?
Hello,
Welcome back to icliniq.com.
If your dog is alive after one year of exposure, then the chance of rabies is very much less. Usually, a normal healthy dog does not carry the virus. The rabies dog cannot survive for one year and it does not seem to be a healthy dog. So you may need not to worry about rabies. The neurological symptoms include mental confusion state, hydrophobia, convulsion, etc.
Direct fluorescent antibody testing, PCR, etc., are different testing methods in saliva, CSF fluid, etc. But it cannot be 100 % diagnostic. The only reliable, confirmatory test is rabies virus identification in brain tissue. But you need not test for rabies as per history and in my opinion. The is no effective treatment for rabies. The only effective treatment is post-exposure prophylaxis with a vaccine within five days of exposure.
Patient's Query
Hello doctor,
Thank you for the reply,
This is the report. Urine culture and sensitivity and vitamin B 12 report will be available for four days.
Hello,
Welcome back to icliniq.com
Your complete blood count report, liver profile, and kidney profile report are normal. So anemia, liver disease, and Kidney disease can be ruled out. Your protein level is also within the limit.
Now you can revert back with other reports once done. It is advisable to consult a nearby physician for a detailed physical examination if your symptoms continue.
I hope I have answered your question.
Regards.
Patient's Query
Hi doctor,
Thank you for the reply,
Here is the remaining report. Please kindly review this report and suggest me a suitable treatment plan.
Hello,
Welcome back to icliniq.com.
Your B12 report is absolutely normal and no treatment is needed for that. Your urine culture report shows greater than 1 lakh colony counts which represents significant bacteriuria. So it is suggestive of urinary tract infection by E. Coli. For that, you can be prescribed Amoxicillin and Clavulanic acid combination drug 625 mg BD for 5 to 7 days. Meanwhile, Cranberry juice and citrus fruit juice can be consumed more.
Drink lots of water as well and avoid excess spicy foods intake to treat UTI. However, you should consult a nearby physician for your detailed evaluation and get a written prescription accordingly.
I hope I have answered your question.
Let me know if I can assist you further.
Regards.
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Pathology
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